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带血管骨移植在四肢骨肿瘤治疗中的应用
Hits: 1720   Download times: 1194   Received:June 21, 1997    
作者Author单位UnitE-Mail
程春生 Cheng Chunsheng 河南省洛阳正骨医院,471002 Luoyang Hospital of Orthopaedics and Traumatology,Henan Province 471002  
赵雅萍 Zhao Yaping 河南省洛阳正骨医院,471002 Luoyang Hospital of Orthopaedics and Traumatology,Henan Province 471002  
张耘 Zhang Yun 河南省洛阳正骨医院,471002 Luoyang Hospital of Orthopaedics and Traumatology,Henan Province 471002  
刘威 河南省洛阳正骨医院,471002 Luoyang Hospital of Orthopaedics and Traumatology,Henan Province 471002  
期刊信息:《中国骨伤》1999年12卷,第3期,第8-10页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:临床观察带血管骨移植修复四肢骨肿瘤瘤段切除后骨缺损的治疗价值。

方法:对48例不同类型的骨肿瘤行局部彻底切刮除,或骨膜外瘤段切除后所致的骨缺损分别采用带血管蒂髂骨瓣转位移植6例,游离移植3例;带血管胫骨瓣游离移植1例;带血管蒂腓骨瓣同侧顺逆行转位移植9例,游离腓骨移植22例,双腓骨瓣组合移植4例,腓骨皮瓣游离移植3例进行修复治疗。

结果:移植骨与主骨均获得愈合,时间为2.5~4.2个月,平均3.5个月。并经0.5~12年(平均4.7年)的随访,45例治愈,;3例复发,复发的3例病人中2例为骨肉瘤,1例为动脉瘤样骨囊肿恶性变,最终行了截肢术。

结论:证明带血管骨移植用于修复病变广泛的良性骨肿瘤或低变恶性骨肿瘤瘤段切除后的骨缺损疗效可靠,恶性肿瘤者较差。
[关键词]:骨肿瘤  骨缺损  骨移植  显微外科
 
Vascularized Bone Transplantation in Treatment of Bone Tumors in Extrimities
Abstract:

Objective:To observe clinically on the therapeutic value of vascularized bone transplantation in the repair of osseous defects in extremities after removal of bone tumors.

Methods: After excision of local tumor or extraperiosteal tumor from 48 patients with various kinds of bone tumors,the osseous defects were treated with vascular pedicle iliac flap transposition grafting in 6 cases,and free iliac grafting in 3;with free vascularized tibial flap grafting in 1;with vascular pedicle fibular flap transposition grafting in 9,and free fibular grafting in 22,combined doublefibular flap grafting in 4,and free fibular skin flap grafting in 3.

Results: The grafted and host bones were union with a healingtime range of 2.5-4.2 months(3.5 months in average).In followingup for 0.5-12 years,there were 45 cases cured and 3 cases recurred.The 3 recurrent cases,including 2 cases of osteosarcoma and one of malignant change of aneurysmlike bone cyst,received amputations at last.

Conclusion: It was demonstrated that vascularized bone grafting is reliable for repairing osseous defect after excision of benign or lower malignant osseous tumor but not good for the malignant.
KEYWORDS:Bone tumorOsseous defect  Bone transplantation  Microsurgery
 
引用本文,请按以下格式著录参考文献:
中文格式:程春生,赵雅萍,张耘,刘威.带血管骨移植在四肢骨肿瘤治疗中的应用[J].中国骨伤,1999,12(3):8~10
英文格式:Cheng Chunsheng,Zhao Yaping,Zhang Yun.Vascularized Bone Transplantation in Treatment of Bone Tumors in Extrimities[J].zhongguo gu shang / China J Orthop Trauma ,1999,12(3):8~10
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